• Journal of Korean Neurosurgical Society
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• v.29 no.9
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• pp.1222-1227
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• 2000

Objective : Vascular endothelial growth factor(VEGF), an endothelial cell specific cytokine, is a potent angiogenic growth factor implicated in the tumor angiogenesis and increases vascular permeability dramatically. Peritumoral brain edema(PTBE) occurs in 40-60% of meningiomas. Many causative factors have been investigated, but the mechanism of PTBE associate with meningioma is unclear. VEGF has been implicated as one of the causative factors of PTBE. This study was designed to determine whether the extent of VEGF expression is correlated with degree of PTBE in meningiomas. Methods : Meningioma tissue samples from 40 patients(7 men and 33 women, mean age $53{\pm}13years$) who underwent surgery were examined retrospectively for the expression of VEGF immunohistochemically. The extent of PTBE was estimated by using preoperative CT or MRI as an edema index(EI). In addition to VEGF, several causative factors including tumor size, location, histologic type, microvasculature(CD31) were compared with EI. Results : Twenty-six meningiomas demonstrated PTBE, and the other 14 did not. Of the 40 patients of meningiomas, 28 were positive(17 were 1+ and 11 were 2+) for VEGF. The EI increased significantly just as VEGF was strongly expressed(p=0.006). Microvascular proliferation was also closely correlated with the extent of peritumoral brain edema(p<0.05). Conclusion : These data suggest that VEGF expression and microvascular proliferation are closely correlated with PTBE in meningioma.

• Progress in Medical Physics
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• v.30 no.4
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• pp.104-111
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• 2019

Purpose: Online magnetic resonance-guided adaptive radiotherapy (MRgART), an emerging technique, is used to address the change in anatomical structures, such as treatment target region, during the treatment period. However, the electron density map used for dose calculation differs from that for daily treatment, owing to the variation in organ location and, notably, air pockets. In this study, we evaluate the dosimetric effect of electron density override on air pockets during online ART for pancreatic cancer cases. Methods: Five pancreatic cancer patients, who were treated with MRgART at the Seoul National University Hospital, were enrolled in the study. Intensity modulated radiation therapy plans were generated for each patient with 60Co beams on a ViewrayTM system, with a 45 Gy prescription dose for stereotactic body radiation therapy. During the treatment, the electron density map was modified based on the daily MR image. We recalculated the dose distribution on the plan, and the dosimetric parameters were obtained from the dose volume histograms of the planning target volume (PTV) and organs at risk. Results: The average dose difference in the PTV was 0.86Gy, and the observed difference at the maximum dose was up to 2.07 Gy. The variation in air pockets during treatment resulted in an under- or overdose in the PTV. Conclusions: We recommend the re-contouring of the air pockets to deliver an accurate radiation dose to the target in MRgART, even though it is a time-consuming method.

• Journal of The Korean Dental Society of Anesthesiology
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• v.9 no.1
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• pp.24-29
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• 2009

When performing the inferior alveolar nerve block anesthesia, surgeon often faced a difficulty of the surgical operation due to the incomplete anesthesia. One of the reason is the variety of mandibular canal anatomy. Up to now, there are some reports of index cases about bifid mandibular canal among mandibular canal anatomic variation, and some classification is applied according to anatomical location and configuration. When surgical operation is performed involving mandible such as dantal implant treatment, extraction of an impacted third molar, sagittal split ramus osteotomy, etc, the position of mandibular canal should be considered. Bifid mandibular canal clinically causes troublesome cases of anesthesia when inferior alvelor nerve block, especially is performed extraction of an impacted third molar. Therefore, It is important for clinicians to recognize the presence of bifid canals on radiographys. Nowadays, the position of mandibular canal can be measured precisely by using Dental CT. It is not found by panorama image but is found by Dental CT sometimes. Among the patients, which take panorama and Dental CT simultaneously, for tooth extraction of lower impacted third molar in our department, we report the case that did not identifying in panorama but identifying it in Dental CT.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6681-6684
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• 2015

Background: Metastatic cancer with invasion of skin, soft tissue and skeletal muscle is not common. Examples presenting as soft tissue masses could sometimes lead to misdiagnosis with delayed or inappropriate management. The purpose of current study was to investigate clinical characteristics in the involvement of metastatic cancer. Materials and Methods: A total of 1,097 patients complaining of skin or soft tissue masses and/or lesions were retrospectively reviewed from January 2012 to June 2013. Tumors involving skin, soft tissue and skeletal muscle of head and neck, chest wall, abdominal wall, pelvic region, back, upper and lower extremities were included in the study. Results: Fifty-seven (5.2%) patients were recognized as having malignancies on histopathological examination. The most common involvement of malignancy was basal cell carcinoma, followed by cutaneous squamous cell carcinoma, sarcoma and melanoma. The most common anatomical location in skin and soft tissue malignancies was head and neck (52.6% of the malignancies). Four (0.36%) of the malignant group were identified as metastatic cancer with the primary cancer source from lung, liver and tonsil and the most common site was upper extremities. One of them unexpectedly expired during the operation of metastatic tumor excision at the scalp. Conclusions: Discrimination between benign and malignant soft tissue tumors is crucial. Performance of imaging study could assist in the differential diagnosis and the pre-operative risk evaluation of metastatic tumors involving skin, soft tissue and skeletal muscle.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.2171-2174
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• 2012

Background: Pancreatic cancer is a distressing disease with a miserable prospects and early recognition remains a challenge due to ubiquitous symptomatic presentation, deep anatomical location, and aggressive etiology. False positives and problems in distinguishing pancreatitis from adenocarcinoma limit the use of CA 19-9 as both disorders can present with similar symptoms and share radiographic physiognomies. This study aimed to assess the relative increase in accuracy of diagnosing the patients with chronic pancreatitis, benign neoplasm of pancreas and adenocarcinomas with CA 19-9, haptoglobin, and serum amyloid A in comparison to CA 19-9 alone. Materials and Methods: This hospital based case control study was carried out in the Departments of Medicine and Biochemistry of Manipal Teaching Hospital, Pokhara, Nepal, between $1^{st}$ January 2010 and $31^{st}$ December 2011. The variables assessed were age, gender, serum CA19-9, serum haptoglobulin, serum Amyloid A. The data were analyzed using Excel 2003, R 2.8.0 Statistical Package for the Social Sciences (SPSS) for Windows Version 16.0 (SPSS Inc; Chicago, IL, USA) and the EPI Info 3.5.1 Windows Version. Results: Out of 197 cases of pancreatic disease, maximum number of assumed cases were of adenocarcinoma of pancreas (95). Number of males (59) were more than females (36) in assumed cases of adenocarcinoma of pancreas. The mean values of CA19-9 raised considerably in cases of chronic pancreatitis, benign neoplasm and adenocarcinoma of pancreas when compared to controls. The highest augmention in CA19-9 values were in cases of adenocarcinoma of pancreas. The p-value indicates that in cases of chronic pancreatitis, there was not significant increase in precision of diagnosis. Conclusions: These statistics established that haptoglobin and SAA are useful in discriminating cancer from benign conditions as well as healthy controls.

• Journal of Korean Ophthalmic Optics Society
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• v.8 no.1
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• pp.41-45
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• 2003

The researchers have studied on the effect of three main morphological types(nuclear, cortical, and subcapsular cataract) of age related cataract on refractive error. We also identified that spherical and cylinderical shift in each type of morphological cataract accoding to their locations and effect of intraocular pressure before and after cataract surgery. Nuclear cataract showed myopic shift while cortical cataract showed hyperopic shift, and subcapsular cataract showed not significant changes on both direction. Age related cataract subjects(120 eyes) only were recruited from sun-cheon area. We use optic section of slit lamp biomicroscope to identify the anatomical location of cataract, and optimal refractive correction determined by objective(retinoscope) and subjective refraction then spherical changes were calculated from the spherical eqivalent value. Intra-ocular pressure were measured by auto-tonometer before and 7 days after cataract has been replaced by IOL. The change in cylindrical power, usually A-P diameter decreased according to increases of age, A-P diameter increased because intra-ocular pressure rises by progression of cataract and this convertion with the rule astigmatism to against the rule astigmatism and this increases more by intra-ocular pressure.

• Journal of Korean Medical classics
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• v.20 no.4
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• pp.17-35
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• 2007

Objectives : To consider same or not the positions of acupoints on the meridian in the old acupuncture books. Methods: On the basis of old acu-books, We count the number of acupoints that are on pulse. Thru the three books-"Yijongkumkam(醫宗金鑑)","Chimkuhak 1st(鍼灸學-上)", Kyunghyulhakchongseo(經穴學叢書)"-We Compared the way of positioning of acupoints, also did on the location of acupoints, vein, vascular system, around the acupoints, based on the anatomical structures(esp. artery) Results : On the basis of old acu-books, the number of acupoints(only in the twelve meridian) on the pulse is 35, and the number of points not in the old books but on the pulse is 6, sum is 41 points. Comparion from Sambukuhu consultation method(三部九候診法) in "Somun(素問)", Some points, Taeyang(太陽, not in the twelve meridian), Yimun(耳門) and Koryo(Yimun and Koryo are in) are on pulse. Like Chonbu(天府) and Hyupbaek(俠白), We can feel the pulse on ulna side of biceps muscle, noton radial side. Shikdu(食竇) was described as on pulse in the "Chimkushimbopyokyul(鍼灸心法要訣)", but we could hardly feel it. Conclusions : It'll be right to add the Yimun(耳門) and Koryo to the points on pulse, of course two points are not in the twelve meridian. We must take the points Chonbu(天府) and Hyupbaek(俠白), on ulna side of biceps muscle. Shikdu(食竇) must be excepted, because we cannot feel the pulse in consultation.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5179-5183
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• 2013

The cerebellar hemangioblastoma (CHB) has an abundant blood supply and deep anatomical location. Complete surgical resection is generally very difficult. This study investigated the safety and effectiveness of preoperative embolization followed by surgical resection of CHB in a large cohort of patients. A database of 125 CHB patients with surgical resection in Beijing Tiantan Hospital between July 2006 and July 2012 was reviewed. Of those, 46 cases (experimental group) received preoperative embolization, 79 cases (control group) underwent surgery without embolization. Patient demographics, tumor size, duration of surgery, blood loss, blood transfusion, complications and follow-up results were collected and analyzed retrospectively. In the experimental group, the Kamofsky score (KS) was 80-100 in 40 cases (86.9%), 40-70 in 4 cases (8.7%), and below 40 in 2 cases (4.3%). Among 31 cases with follow-up, KS was 80-100 in 27 cases (87.1%), 40-70 in 2 cases (6.5%), and 0 in 2 cases (6.5%). In control group, KS was 80 -100 in 65 cases (82.2%), 40-70 in 6 cases (7.6%), 10-30 in 3 cases (3.8%), and 0 in 3 cases (3.8%). Among 53 cases with follow-up, KS was 80-100 in 44 cases (83.0%), 40-70 in 4 cases (7.5%), 10-30 in 1 case (1.9%), and 0 in 4 cases (7.5%). There were statistically significant differences between the experimental and control groups in tumor size, duration of surgery, amount of intraoperative blood loss and transfusion (p<0.01). However, complications (p=0.31) and follow-up results (p=0.76) showed no significant differences between groups. Selective preoperative embolization of those CHB patients with richer blood supply, higher hemorrhage risk, is safe and effective, and is a reliable adjuvant therapy for complete surgical resection of CHB.

• Journal of Yeungnam Medical Science
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• v.32 no.1
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• pp.31-34
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• 2015

In Korea, cases of direct insertion of foreign bodies into the rectum are rare in the literature. Most cases of rectal insertion of foreign bodies are associated with sexual acts and psychiatric disorder such as schizophrenia. Objects inserted into the anus are usually blunt and shaped like the male genitalia. The removal method can be varied depending on the size and shape of the foreign object, its anatomical location, and the accompanying complications. In cases wherein attempts to remove the object fail or there are rectal perforation and peritonitis complications, immediate laparotomy may be required in order to prevent serious complications such as sepsis. Here, we report on a case of rectal perforation and peritonitis due to insertion of a foreign body in a middle-aged patient, with a literature review. He inserted a sharp pig backbone in his rectum and he only had depression. The patient underwent a Hartmann's operation as well as psychiatric counseling and treatment. Thus, after removal of foreign bodies, psychiatric counseling and treatment should be carried out in order to prevent similar accidents and to minimize the need for trauma medicine.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.24-28
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• 2009

Purpose: As a recipient vessel, internal mammary vessels have many advantages for microvascular reconstruction of the breast. But the approach is time consuming and results in large morbidities. However, the perforating branches of the internal mammary vessels can be used to minimize such demerits. The purpose of this cadaver study is to clarify the location and diameter of the perforating branches of internal mammary vessels and to prove they are safe and reliable recipient vessels. Methods: We studied 11 formalin - fixed cadavers and dissected their anterior chests bilaterally. The chests were exposed using midline presternal incisions. We dissected and found all perforators at subfascial planes under loupe magnification. The number, external diameter, and the distance from the midline were measured. Result: The mean external diameter of the arterial perforators was 1.32 mm and the mean external diameter of the venous perforators was 1.48 mm. The largest arterial and venous perforators were most frequently found in the second intercostal space. The mean distance from the midline to the perforator was evaluated; the artery averaged 1.95 cm and the vein averaged 2.08 cm. Conclusion: This study will be helpful when using the internal mammary perforating vessels as a recipient vessel during breast reconstruction.